SEED - Clinic Visit- Case Parent

The Study to Explore Early Development (SEED)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0741 can be found here:

Documents and Forms

Document Name Document Type
Form No number SEED - Clinic Visit- Case Parent Form and Instruction
No number Appendix F. 3 Services and Treatment Q Appendix F.3 Services and Treatment Q 2007 06.doc Form and Instruction
No number Appendix E.3 Informed Consent Appendix E.3 Informed Consent Docs.doc Form and Instruction
No number Appendix E.3 Informed Consent NIC & Sub Appendix E.3 Informed Consent NIC&Sub6-4-2007.doc Form and Instruction
No number Appendic F.2 EDQ Appendix F.2 EDQ.doc Form and Instruction
No number Appendix F.4 Vineland Appendix F.4 Vineland.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	SEED - Clinic Visit- Case Parent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	No number	Appendix F. 3 Services and Treatment Q	Appendix F.3 Services and Treatment Q 2007 06.doc	Yes	Yes	Fillable Printable
Form and Instruction	No number	Appendix E.3 Informed Consent	Appendix E.3 Informed Consent Docs.doc	Yes	Yes	Fillable Printable
Form and Instruction	No number	Appendix E.3 Informed Consent NIC & Sub	Appendix E.3 Informed Consent NIC&Sub6-4-2007.doc	Yes	Yes	Fillable Printable
Form and Instruction	No number	Appendic F.2 EDQ	Appendix F.2 EDQ.doc	Yes	Yes	Fillable Printable
Form and Instruction	No number	Appendix F.4 Vineland	Appendix F.4 Vineland.pdf	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 3,456	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,050	4,050
Annual IC Time Burden (Hours)	2,700	2,700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.